Key Activities and Strategies:
1) Increase number of providers trained to prescribe PrEP 2) Increase PrEP prescriptions among priority populations
Key Partners: Community-based organizations, FQHCs, sexual health clinics, hospitals, social media platform providers, social service providers, etc.
Potential Funding Resources: CDC HIV Prevention and Surveillance Programs, Bureau of Primary Health Care (Health Centers), State and/or Local Funding, Minority AIDS Initiative (MAI), SAMHSA, HOPWA, Federal Office of Rural Health Policy, Indian Health Service;
Office on Women’s Health, Office of Minority Health, Office of Population Affairs, and other public and private funding sources, etc.
Estimated Funding Allocation: $X
Outcomes (reported annually, locally monitored more frequently): # of providers trained; # of prescriptions for PrEP
Monitoring Data Source: Local databases, medical records data, pharmacy records
Expected Impact on Status Neutral Approach: Increase by XX number the people prescribed PrEP, Increase by XX number the people linked to PrEP services, Increase by XX% in the number of syringe services programs available
Respond (EXAMPLE)
Goal: To increase capacity and implementation of activities for detecting and responding to HIV clusters and outbreaks in 5 years.
Key Activities and Strategies:
1) Increase involvement of health department staff, community members, and community organizations in response planning, implementation, and evaluation
2) Increase flexible funding mechanisms capable of supporting HIV cluster response efforts Key Partners: Community members, community-based organizations, HIV care providers, FQHCs, correctional facilities, hospitals, social services providers, people with HIV, health departments, public health professionals, etc.
Potential Funding Resources: CDC HIV Prevention and Surveillance Programs, STD Funding, RWHAP, SAMHSA, HUD/HOPWA, Medicaid, Bureau of Primary Health Care (Health
Centers), viral hepatitis funding, opioid/substance use funding, State and/or Local Funding Estimated Funding Allocation: $X
Outcomes (reported annually, locally monitored more frequently): Establishment of strengthened cluster and outbreak detection and response plans; protocols for flexible funding mechanisms; number of clusters detected; number and description of cluster responses and lessons learned; incorporation of strategies from Diagnose, Treat, and Prevent pillars into responses to clusters.
Monitoring Data Source: Local protocols and reports
Expected Impact on Status Neutral Approach: Increase the number of people in networks affected by rapid transmission who know their HIV diagnosis, are linked to medical care, and are virally suppressed, or who are engaged in appropriate prevention services (e.g., PrEP, syringe services programs)
Appendix 3
Examples of Key Stakeholders and Community Members
Community engagement is a key expectation of the Integrated Planning Guidance. Community engagement involves the collaboration of key stakeholders and broad-based communities who work together to identify strategies to increase coordination of HIV programs throughout the state, local health jurisdictions, or tribal areas. Each community should select stakeholders including persons with HIV who reflect the local demographics of the epidemic with lived experience and can best help align resources and set goals that promote equitable HIV prevention and health outcomes for priority populations. This should include not only traditional
stakeholders but engagement with new partners and non-traditional organizations. While the Integrated Plan submission should be done in collaboration with identified Integrated Planning body(s), community engagement may also include assessment processes (e.g., focus groups, population-specific advisory boards) that take place outside of or in conjunction with the Integrated HIV Care and Prevention body(s) and to inform the Integrated Plan submission.
Please Note: Persons or groups with a “*” must be included in the planning process to meet HRSA and/or CDC’s legislative or programmatic requirements.
Key Stakeholders to Consider for Planning Group Membership
• Health department staff*
• Community- based organizations serving populations affected by HIV as well as HIV services providers*
• People with HIV, including members of a Federally recognized Indian tribe as represented in the population, and individuals co-infected with hepatitis B or C*
• Populations at risk or with HIV representing priority populations
• Behavioral or social scientists
• Epidemiologists
• HIV clinical care providers including (RWHAP Part C and D)*
• STD clinics and programs
• Non-elected community leaders including faith community members and business/labor representatives*
• Community health care center representatives including FQHCs*
• Substance use treatment providers*
• Hospital planning agencies and health care planning agencies*
• Intervention specialists
• Jurisdictions with CDC- funded local education agencies/academic institutions (strongly encouraged to participate).
• Mental health providers*
• Individuals (or representatives) with an HIV diagnosis during a period of incarceration (within the last three years) at a federal, state, or local correctional facility*
• Representatives from state or local law enforcement and/or correctional facilities
• Social services providers including housing and homeless services representatives*
• Local, regional, and school-based clinics; healthcare facilities; clinicians; and other medical providers
• Medicaid/Medicare partners
Examples of Key Stakeholders to Consider for Community Engagement
• Existing community advisory boards
• Community members resulting from new outreach efforts
• Community members that represent the demographics of the local epidemic (e.g., race, ethnicity, gender, age, etc.)
• Community members unaligned or unaffiliated with agencies currently funded through HRSA and/or CDC
• STD clinics and programs
• Other key informants
• City, county, tribal, and other state public health department partners
• Local, regional clinics, and school-based healthcare facilities; clinicians; and other medical providers
• Medicaid/Medicare partners and private payors
• Correctional facilities, juvenile justice, local law enforcement and related service providers
• Community- and faith-based organizations, including civic and social groups
• Professional associations
• Local businesses
• Local academic institutions
• Other key informants
Examples of Community Engagement Activities
• Focus groups or interviews
• Town hall meetings
• Topic-focused community discussions
• Community advisory group or ad hoc committees or panels
• Collaboration building meetings with new partners
• Public planning body(s) meetings or increased membership
• Meetings between state and local health departments
• Social media events
Appendix 4
Suggested Data Sources Suggested Data Sources:
• Behavioral surveillance data, including databases such as National HIV Behavioral Surveillance System (NHBS), Youth Risk Behavioral Surveillance System (YRBSS), Behavioral Risk Factor Surveillance System (BRFSS) (e.g., patterns of, or deterrents to, HIV testing, substance use and needle sharing, sexual behavior, including unprotected sex, sexual orientation and gender identity, healthcare-seeking behavior, trauma or intimate partner violence, and adherence to prescribed antiretroviral therapies)
• HIV surveillance data, including clinical data (e.g., CD4 and viral load results) and HIV cluster detection and response data. HIV Surveillance Report, Supplemental Reports, and Data Tables: https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
• STI surveillance data
• HIV testing program data (e.g., data from Early Identification of Individuals with HIV/AIDS for RWHAP Parts A and B Grantees; CDC HIV testing data)
• NCHHSTP AtlasPlus (HIV, STD, Hepatitis, TB, and Social Determinants):
https://www.cdc.gov/nchhstp/atlas/index.htm?s_cid=ss_AtlasPlusUpdate001
• Medical Monitoring Project: https://www.cdc.gov/hiv/statistics/systems/mmp/index.html
• Ryan White HIV/AIDS Program data (Ryan White HIV/AIDS Program Services Report;
ADAP Data Report): https://hab.hrsa.gov/data/data-reports
• AHEAD: America’s HIV Epidemic Analysis Dashboard: https://ahead.hiv.gov/
• HOPWA EHE Planning Tool: https://ahead.hiv.gov/resources
• Other relevant demographic data (i.e., Hepatitis B or C surveillance, tuberculosis surveillance, and substance use data)
• Qualitative data (e.g., observations, interviews, discussion groups, focus groups, and analysis of social networks)
• Vital statistics data (e.g., state office of vital statistics, National Death Index, Social Security Death Master File)
• Other Federal Data Sources (e.g., Medicaid Data, HOPWA Data, VA Data)
• Local Data Sources (e.g., Department of Corrections, Behavioral Health services data including information on substance use and mental health services )
• Other Relevant Program Data: (e.g. Community Health Center program data).
Note: An update to the Integrated Guidance for Developing Epidemiologic Profiles is forthcoming in late 2021.
References for CDC DHAP and HRSA HAB Performance Measures:
• HRSA HAB Performance Measure Portfolio: https://hab.hrsa.gov/clinical-quality-management/performance-measure-portfolio
• Core Indicators for Monitoring the Ending the HIV Epidemic: https://ahead.hiv.gov/
Appendix 5
Federal Strategic Plans and Resources Federal Strategic Planning Documents
• Healthy People 2030: Sets data-driven national objectives to improve health and well-being over the next decade.
• HIV National Strategic Plan: A Roadmap to End the HIV Epidemic (2021– 2025):
Roadmap for ending the HIV epidemic in the United States, with a 10-year goal of reducing new HIV infections by 90% by 2030.
• Sexually Transmitted Infections National Strategic Plan for the United States (2021– 2025):
Groundbreaking, first ever five-year plan that aims to reverse the recent dramatic rise in STIs in the United States
• Viral Hepatitis National Strategic Plan: A Roadmap to Elimination 2021-2025: Provides a framework to eliminate viral hepatitis as a public health threat in the United States by 2030.
• HHS Ending the HIV Epidemic (EHE): A Plan for America Initiative: EHE aims to reduce the number of new HIV infections in the United States by at least 90% to fewer than 3,000 per year.
Federal HIV Funding Resources
This non-exhaustive list provides web sites to assist with identifying federal HIV funding resources in U.S. jurisdictions.
General
• USA Spending
• Federal HIV Budget
Health Resources and Services Administration (HRSA)
• HRSA HIV/AIDS Programs – Grantee Allocations & Expenditures
• HRSA Bureau of Primary Health Care Health Center Recipients Locator
• HRSA Federal Office of Rural Health Policy, Rural Assistance Center, Rural HIV and AIDS Funding & Opportunities
Centers for Disease Control and Prevention (CDC)
• CDC Division of HIV/AIDS Prevention (DHAP) Funding and Budget
• Notice of Funding Opportunity (NOFO) PS19-1906: Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States Component B: Accelerating State and Local HIV Planning to End the HIV Epidemic
• Ending the Epidemic (EHE): Scaling Up HIV Prevention Services in STD Specialty Clinics
• CDC DIS Workforce Development Funding
U.S. Department of Housing and Urban Development (HUD)
• HUD Community Planning and Development Program Listing
• HUD Community Planning and Development – Cross-Program Funding Matrix and Dashboard Reports
Substance Abuse and Mental Health Services Administration (SAMHSA)
• SAMHSA's Substance Abuse and HIV Prevention Navigator Program for Racial/Ethnic Minorities
• SAMHSA Grant Awards by State
• SAMHSA’s Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders
HHS, Office on Minority Health (OMH)
• HHS Office of Minority Health Active Grant Award Locator National Institutes of Health
• Centers for AIDS Research (CFAR) program
CDC/HRSA Project Officer
Appendix 6
Sample Letter of Concurrence or Concurrence with Reservations between Planning Body and State or Local Health Department or Funded Agency
Dear (Name):
The [insert name of Planning Body, e.g. planning council, advisory council, HIV planning group, planning body] [insert concurs or concurs with reservations] with the following submission by the [insert name of State/Local Health Department/ Funded Agency] in response to the guidance set forth for health departments and HIV planning groups funded by the CDC’s Division of HIV/AIDS Prevention (DHAP) and HRSA’s HIV/AIDS Bureau (HAB) for the development of an Integrated HIV Prevention and Care Plan, including the Statewide Coordinated Statement of Need (SCSN) for calendar year (CY) 2022-2026.
The planning body (e.g. planning council, advisory council, HIV planning group, planning body) has reviewed the Integrated HIV Prevention and Care Plan submission to the CDC and HRSA to verify that it describes how programmatic activities and resources are being allocated to the most disproportionately affected populations and geographical areas with high rates of HIV. The planning body [insert concurs or concurs with reservations] that the Integrated HIV Prevention and Care Plan submission fulfills the requirements put forth by the CDC’s Notice of Funding Opportunity for Integrated HIV Surveillance and Prevention Programs for Health Departments and the Ryan White HIV/AIDS Program legislation and program guidance.
[Insert the process used by the planning body to provide input or review the jurisdiction’s plan.]
[If applicable, insert how jurisdictions with directly funded states and cities plan to coordinate their HIV Planning process.]
The signature(s) below confirms the [insert concurrence or concurrence with
reservations] of the planning body with the Integrated HIV Prevention and Care Plan.
Signature: Date:
Planning Body Chair(s)